Brent Dual Diagnosis

Project

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Service History • 1998 Brent Mind establish service 5 placements

• 2000 Additional 6 BME placements

• 2004 Supporting people housing related funding

• 2005 Remodel, introduction of structured groups

• 2006 New provider St Mungos add specialist input

Stakeholders

• Brent PCT ( 70% funding /

referrals ) )

• Supporting People ( 30% funding )

• Paddington Churches ( Houses the service )

• St Mungos ( Manages the

contract )

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Aims of the service

• Assist people who need support in the community around mental health and substance use issues.

• Reduce compulsory hospital admissions.

• Reduce severity and frequency of risk behaviour by promoting harm reduction around substance

use.

• The service values people for who they are and share their vision of achieving independence.

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Aims of the Service

• Promotes Social & life skills, Tenancy sustainment, Personal development and the belief that recovery is obtainable.

• Promote recovery and maximise wellbeing, supporting tenants to meet their long term aspirations.

Dual diagnosis / homelessness

• Historically ( prior to being referred to the service ) clients spend long periods in a transitory state revolving through various short term accommodations.

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Transitory accommodation

• Family Home (Breakdown)

• Independent Tenancies (Failed)

• Hospital (Revolving door lack of move on provision bed blocking )

• B & Breakfast ( short term to address lack of move on provision)

• Supported Accommodation (Short to medium ) • Prison ( to a far lesser degree )

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Impact of remaining on the homeless threshold

• Lack of integrated service provision

• Viewed as hard to engage / problematic

• Vulnerable to exploitation

• Entrenched substance use

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Service Profile

• 18 Months Tenancy / 6 months Floating Support• 2 week trial period ( attending day programme )

• Groups AM Daily Tenant meeting, current affairs, self development , Tenancy sustainment & Drug group

• Groups PM DailyArt class, Relaxation , Shiatsu, Tai Chi, Life skills cooking

• 1 – 1 Sessions Weekly Keyworker, Substance use & Psychotherapist

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Substance use Role

• Bridges the historical gap in service provisions• Sign posts and introduces tenants to external drug

agencies • Substance use interventions tailored to the individual

(harm reduction) ( Peek into abstinence )

• Weekly engagement in group and 1 – 1 sessions• Inspire tenants to practice abstinence through informed

choice

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Psychotherapy role

• Provide a safe environment where Clients areencouraged to talk about and explore their feelings, behaviour and inner conflict.

• Find new ways in which to alleviate stress

• Clinical supervision / reflective practice which provides a forum for frontline staff to present, discuss and share ideas and thoughts on how to holistically address the complex issues faced by clients.

Outcomes of the service

• Move on • 20% Moved into Independent

accommodation ( private rented)

• 75% Moved into lower supported accommodation ( self contained )

• 5% Moved into medium/high support

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Outcomes

• Hospital admissions greatly reduced • Greater awareness of substance use in

relation to mental health.• Increased talk & alternative therapies• Engagement of service user across a

wider range of issues • No evictions planned moves

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Innovations & User Involvement

• There is a scarcity of Dual Diagnosis services

( Locally or Nationally ) that are effective.

• The Project provides a structured supportive

environment that considers clients needs beyond medication and Housing.

• Engages clients holistically using a range of

interventions , models and informative groups

Innovations & User Involvement

• Tenants that have moved on have access to daily

programmes as well as specialists.• Local user involvement – includes

• Service User Magazine – Quarterly “Your vibes today”

• Workshops & Forums – Q&A’s

• Action Plans & Outcomes Stars

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Why Replication ?

• The Service profile in terms of high levels of engagement ensure that vulnerable adults can address issues within a supportive rather than punitive environment.

• Floating support ensures that the transition from high to low / independent living is consistent.

• The theory that clients ( any clients ) are hard to engage will not and does not hold

Why Replication ?

• Local and National services will be able to network and benchmark, ensuring a consistent approach in working in the community with clients with complex needs.

• The question of who treats what and when will be addressed through integrated working.

• The belief that recovery is possible will ensure services work with clients where they are and not where they are expected to be.

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